Healthcare Provider Details

I. General information

NPI: 1659487684
Provider Name (Legal Business Name): IHOR MAGUN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 NASSAU BLVD STE B
WEST HEMPSTEAD NY
11552-2247
US

IV. Provider business mailing address

1010 NORTHERN BLVD STE 328
GREAT NECK NY
11021-5329
US

V. Phone/Fax

Practice location:
  • Phone: 516-656-1919
  • Fax: 833-968-3330
Mailing address:
  • Phone: 516-233-2484
  • Fax: 516-304-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number164151
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: